Better starts for breastfeeding

Thursday

Aug 23, 2012 at 6:00 AM

By Karthi Streb and Marianne McPherson

Every day, millions of women make a choice of whether or not to breastfeed their babies. Science certainly supports the natural option of breastfeeding, and medical and public health groups from the World Health Organization to the American Academy of Pediatrics strongly endorse it.

Breastfeeding provides many well-documented health benefits for the child and the mother. For infants, it decreases the incidence and severity of many infectious diseases, helps in neurodevelopment, and reduces mortality. It also decreases an infant’s risk of becoming obese later in childhood. For moms, breastfeeding decreases the risk of ovarian and breast cancers, cardiovascular diseases, diabetes and rheumatoid arthritis.

Given these benefits and recommendations, the statistics are surprising: Half of U.S.-born babies receive formula within their first week. One in four babies has never had breast milk. At nine months, less than one-third is breastfeeding at all. Why the disconnect between science and practice?

As mothers who have chosen to breastfeed our infants in the past year while returning to work, and as professionals working for an organization leading a national initiative that aims to increase breastfeeding rates, we believe we offer a unique perspective on this question.

Breastfeeding has been the subject of much heated debate in recent months. Most of the discourse has missed a key point: It is the mother’s choice, and we need to support her choice. For the mother who chooses not to breastfeed, we need to remove the judgment. Breastfeeding is not the right (or even feasible) option for everyone, for a myriad of reasons. For mothers who do choose breastfeeding, we need to make it easier, particularly in the hospital, during the first hours of a baby’s life.

We know from our own experiences that those precious postpartum moments are critical in shaping the longer-term breastfeeding journey. We both were committed to breastfeeding, but found it extremely challenging to follow through on that commitment. If not for the compassionate staff in the hospitals where we gave birth, we might not have been successful. Our common experience included immediate skin-to-skin contact, rooming in (babies not sleeping in the nursery), and hands-on assistance with proper breastfeeding techniques. These are just a few of the many ways that the hospital supported our decision to breastfeed during our post-birth moments of absolute joy — and complete exhaustion.

Our personal and professional experiences, however, have taught us that not all moms who choose to breastfeed are supported at the hospital in this way. The organization we work for is helping to address this issue through a project that aims to improve maternity care practices in U.S. hospitals. Those that complete the program are declared “Baby-Friendly,” a global designation indicating that the hospital employs the best maternity care practices to support breastfeeding mothers. It’s an opportunity for hospitals and the clinicians who work there to “walk the walk” of supporting breastfeeding in a meaningful way. Hospitals will follow the road map of the World Health Organization’s Ten Steps to Successful Breastfeeding. One of these steps is the elimination of free distribution of baby formula. In June, Massachusetts made headlines with “ban the bag” legislation that prevents this long-accepted practice.

Breastfeeding is a complex social, cultural and physical issue, affecting a new mother at one of the most vulnerable times of her life. August is National Breastfeeding Month. Let’s mark the occasion by helping to make the healthy choice an easy choice for moms everywhere.

Marianne McPherson, Ph.D., M.S., and Karthi Streb, M.P.H., help lead the National Initiative for Children’s Healthcare Quality “Best Fed Beginnings” initiative. NICHQ is a nonprofit organization based in Boston.